Organization
NORTHSIDE HOSPITAL INC
Active
Other names
Northside Hospital Gwinnett Outpatient Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
AMY E FOUTS (CHIEF COMPLIANCE OFFICER)
(404) 851-6968
Entity
Organization
Contact information
Practice address
1000 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30046-7694
(678) 312-4233
Mailing address
1000 JOHNSON FERRY RD, ATLANTA, GA 30342-1606
(404) 851-8000
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
05/05/2020
Last updated
06/12/2026
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